ABSTRACT Children with oral clefts are at increased risk for learning problems compared to unaffected children. Deficits are observed in multiple academic areas, and are most pronounced in reading and language-mediated skills. Despite these findings, there are no published studies testing the effectiveness of intervention or prevention efforts to offset these disparities. The long-term goal for this research is to create treatment and research protocols that would enable us to complete the first randomized controlled trial (RCT) of a parent- focused literacy intervention. We plan to model this intervention after the Reach Out and Read program that has been used successfully in pediatric primary care settings with infants at elevated risk for poor literacy and academic achievement outcomes. Adaptations will include strategies to facilitate implementation in craniofacial team care settings, delivered by speech/language pathologists, and to tailor the intervention to the needs of children with oral clefts. The specific aims for this treatment development (R34) proposal include: (1) Evaluate acceptability and feasibility in traditionally under-represented families (e.g., Latino/Hispanic families, children from low socioeconomic backgrounds), and in craniofacial team settings; (2) Create written protocols for the implementation of an RCT (e.g., treatment manual, research protocol and manual of operations); and (3) Establish collaboration between participating centers (Seattle Children's Hospital, Children's Hospital Los Angeles).